Healthcare Provider Details

I. General information

NPI: 1184650855
Provider Name (Legal Business Name): BENEFIS HEALTHCARE PRACTITIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 28TH ST S SUITE 10
GREAT FALLS MT
59405-5296
US

IV. Provider business mailing address

2519 13TH AVE S
GREAT FALLS MT
59405-5178
US

V. Phone/Fax

Practice location:
  • Phone: 406-455-4320
  • Fax: 406-452-0769
Mailing address:
  • Phone: 406-455-4470
  • Fax: 406-268-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL J REINER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 406-455-4470